AB0660 PREDICTIVE PARAMETERS FOR THE DEVELOPMENT OF PERIPHERAL NEUROPATHIES IN PRIMARY SJÖGREN’S SYNDROME
Authors: A. Mihai, C. Diana Maria, C. Jurcut, B. Cristian Florin, N. Adriana Elena, D. Opris-Belinski, R. Ionescu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sjögren's syndrome is a heterogeneous inflammatory disorder frequently involving peripheral nerves with a significant clinical and prognostic impact. The early detection of hematological and immunological parameters might improve disease control and even patients' survival. <h3>Objectives</h3> The objective of this study was to evaluate the predictive potential of hematological and immunological elements for the development of peripheral neuropathies (PN) in pSS patients. <h3>Methods</h3> In this single-centre, retrospective study, a total of 252 participants were included (131 pSS patients and 121 healthy controls). According to the neurologic examination and the result of the neuro electrophysiological examination, these patients were divided into two groups, with and without PN. Complete blood count, inflammatory and immunological parameters were determined at the initial visit. All patients underwent a periodical follow-up program when disease progression and response to therapy were monitored, including the emergence of PN. <h3>Results</h3> In pSS patients, cellular count, Vitamin B12 and D values were significantly decreased compared to healthy subjects (p &lt; 0.001), whereas cellular ratio- NLR, PLR, immunological and inflammatory parameters were significantly increased (p &lt; 0.001). In the PN patients group (41 patients 31.29%), gammaglobulins negatively correlated with vitamin B12 and total proteins (p &lt; 0.05), while ESSDAI scores positively correlated with NLR and PLR (p &lt; 0.05). The multivariate analysis confirmed the independent predictive character for PN emergence in pSS for NLR (CI95% 0.034 to 0.254, p &lt; 0.010), gammaglobulins (CI95% -0.409 to -0.114, p &lt; 0.001), vitamin B12 (CI95% -0.001 to -0.001, p &lt; 0.001) and vitamin D (CI95% -0.018 to -0.006, p &lt; 0.001). <h3>Conclusion</h3> Standard hematological and immunological parameters, widely used in assessing pSS patients, such as NLR, gammaglobulins, vitamin B12 and D, could become valid elements that might be used for the early detection of patients at risk for the development of PN. The hematological parameters related to platelets appear to be modified in patients with SS and cutaneous manifestations. However, only the neutrophil-to-lymphocyte ratio is independently associated with cutaneous involvement in these patients. <h3>References</h3> [1]C. Vitali, S. Bombardieri, R. Jonsson, H.M. Moutsopoulos, E.L. Alexander, S.E. Carsons, T.E. Daniels, P.C. Fox, R.I. Fox, S.S. Kassan, S.R. Pillemer, N. Talal, M.H. Weisman, Classification criteria for Sjögren's syndrome: A revised version of the European criteria proposed by the American-European Consensus Group, Ann. Rheum. Dis. 61 (2002) 554–558. https://doi.org/10.1136/ard.61.6.554. [2]R.I. Fox, Extraglandular Manifestations of Sjögren's Syndrome (SS): Dermatologic, Arthritic, Endocrine, Pulmonary, Cardiovascular, Gastroenterology, Renal, Urology, and Gynecologic Manifestations, in: Sjögren's Syndr., Springer New York, 2011: pp. 285–316. https://doi.org/10.1007/978-1-60327-957-4_17. [3]A. Alunno, F. Carubbi, E. Bartoloni, P. Cipriani, R. Giacomelli, R. Gerli, The kaleidoscope of neurological manifestations in primary Sjögren's syndrome, Clin. Exp. Rheumatol. 37 (2019) S192–S198. [4]Mihai A, Caruntu A, Opris-Belinski D, Jurcut C, Dima A, Caruntu C, Ionescu R. The Predictive Role of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Monocytes-to-Lymphocyte Ratio (MLR) and Gammaglobulins for the Development of Cutaneous Vasculitis Lesions in Primary Sjögren's Syndrome<i>. J Clin Med</i>. 2022 <i>Sep 21</i>;11(19):5525. <h3>Disclosure of Interests</h3> None declared